Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies

doi:10.1136/bmj.38302.504063.8F

BMJ, doi: 10.1136/bmj.38302.504063.8F, (Published 13 December 2004)

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Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies

Mahyar Etminan ¹, Bahi Takkouche ², Francisco Caamaño Isorna ², Ali Samii ³

¹ Divisions of Epidemiology, Royal Victoria and Vancouver Hospitals, Canada
² Department of Preventive Medicine, University of Santiago de Compostela, Spain
³ Department of Neurology, University of Washington, Seattle, WA 98195, USA

Objective To explore the association between migraine and riskof ischaemic stroke.

Design Systematic review and meta-analysis.

Datasources Observational studies published between 1966 and June2004 (identified through Medline and Embase) that examined theassociation between migraine and risk of ischaemic stroke.

Results14 studies (11 case-control studies and 3 cohort studies) wereidentified. These studies suggest that the risk of stroke isincreased in people with migraine (relative risk 2.16, 95% confidenceinterval 1.89 to 2.48). This increase in risk was consistentin people who had migraine with aura (relative risk 2.27, 1.61to 3.19) and migraine without aura (relative risk 1.83, 1.06to 3.15), as well as in those taking oral contraceptives (relativerisk 8.72, 5.05 to 15.05).

Conclusions Data from observationalstudies suggest that migraine may be a risk factor in developingstroke. More studies are needed to explore the mechanism ofthis potential association. In addition, the risk of migraineamong users of oral contraceptives must be further investigated.

(Accepted 9 November 2004)

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